Iron-based mixotrophic denitrification for enhancing nitrate removal from municipal secondary effluent: Performance, microbial community dynamics, and economic feasibility.

High nitrate content limits the recycling of the secondary effluent of wastewater treatment plants. In the research, one biomass-iron mixture (BIM) filter material based on mixotrophic denitrification mode (heterotrophic and iron-driven autotrophic denitrification) was developed and used to construct a novel denitrification biological filter (BIM-DNBF) for the nitrogen removal of secondary effluent. BIM-DNBF had a short start-up time (approximately 9 days), and high total nitrogen removal (81 %-89 %) without external addition of organic carbon sources during the whole operation. The coexistence of dominant heterotrophic-denitrification-like Pseudomonas and Erysipelothrix as well as iron-driven autotrophic-denitrification-like Citrobacter, Acidovorax, etc. were found in the BIM-DNBF. Moreover, biomass was recognized as one key player in promoting the reduction of Fe3+ to Fe2+, thereby facilitating the occurrence of iron-driven autotrophic denitrification. In addition, BIM-DNBF was assessed to be affordable. These findings provide evidence that BIM-DNBF can be an efficient technology for nitrogen removal of secondary effluent.

Stability assessment of surrounding rock in downward mining route supported by slab-wall backfill structure.

Characteristic of ground pressure in surrounding rock is generally considered as the theoretical basis of parameter optimization for stope structure and technology. To explore the feasibility of efficient method for the second-step downward route backfill stopes in Shanjin gold mine, various numerical simulation methods were used to investigate the effect of slab-wall backfill structure on stability of surrounding rock in downward route mining system. The maximum principal stress, artificial false roof stress, and displacement were analyzed to evaluate the level of ground pressure in different mining areas. These results indicate the optimized structural parameters for backfill stopes, which may also provide a low-cost way to achieve a high safety for downward route mining system.

LiverRisk score: An accurate, cost-effective tool to predict fibrosis, liver-related, and diabetes-related mortality in the general population.

BACKGROUND: Noninvasive and early assessment of liver fibrosis is of great significance and is challenging. We aimed to evaluate the predictive performance and cost-effectiveness of the LiverRisk score for liver fibrosis and liver-related and diabetes-related mortality in the general population. METHODS: The general population from the NHANES 2017-March 2020, NHANES 1999-2018, and UK Biobank 2006-2010 were included in the cross-sectional cohort (n = 3,770), along with the NHANES follow-up cohort (n = 25,317) and the UK Biobank follow-up cohort (n = 17,259). The cost-effectiveness analysis was performed using TreeAge Pro software. Liver stiffness measurements ≥10 kPa were defined as compensated advanced chronic liver disease (cACLD). FINDINGS: Compared to conventional scores, the LiverRisk score had significantly better accuracy and calibration in predicting liver fibrosis, with an area under the receiver operating characteristic curve (AUC) of 0.76 (0.72-0.79) for cACLD. According to the updated thresholds of LiverRisk score (6 and 10), we reclassified the population into three groups: low, medium, and high risk. The AUCs of LiverRisk score for predicting liver-related and diabetes-related mortality at 5, 10, and 15 years were all above 0.8, with better performance than the Fibrosis-4 score. Furthermore, compared to the low-risk group, the medium-risk and high-risk groups in the two follow-up cohorts had a significantly higher risk of liver-related and diabetes-related mortality. Finally, the cost-effectiveness analysis showed that the incremental cost-effectiveness ratio for LiverRisk score compared to FIB-4 was USD $18,170 per additional quality-adjusted life-year (QALY) gained, below the willingness-to-pay threshold of $50,000/QALY. CONCLUSIONS: The LiverRisk score is an accurate, cost-effective tool to predict liver fibrosis and liver-related and diabetes-related mortality in the general population. FUNDING: The National Natural Science Foundation of China (nos. 82330060, 92059202, and 92359304); the Key Research and Development Program of Jiangsu Province (BE2023767a); the Fundamental Research Fund of Southeast University (3290002303A2); Changjiang Scholars Talent Cultivation Project of Zhongda Hospital of Southeast University (2023YJXYYRCPY03); and the Research Personnel Cultivation Program of Zhongda Hospital Southeast University (CZXM-GSP-RC125).

A low-cost machine learning framework for predicting drug-drug interactions based on fusion of multiple features and a parameter self-tuning strategy.

Poly-drug therapy is now recognized as a crucial treatment, and the analysis of drug-drug interactions (DDIs) offers substantial theoretical support and guidance for its implementation. Predicting potential DDIs using intelligent algorithms is an emerging approach in pharmacological research. However, the existing supervised models and deep learning-based techniques still have several limitations. This paper proposes a novel DDI analysis and prediction framework called the Multi-View Semi-supervised Graph-based (MVSG) framework, which provides a comprehensive judgment by integrating multiple DDI features and functions without any time-consuming training process. Unlike conventional approaches, MVSG can search for the most suitable similarity (or distance) measurement among DDI data and construct graph structures for each feature. By employing a parameter self-tuning strategy, MVSG fuses multiple graphs according to the contributions of features' information. The actual anticancer drug data are extracted from the authoritative public database for evaluating the effectiveness of our framework, including 904 drugs, 7730 DDI records and 19 types of drug interactions. Validation results indicate that the prediction is more accurate when multiple features are adopted by our framework. In comparison to conventional machine learning techniques, MVSG can achieve higher performance even with less labeled data and without a training process. Finally, MVSG is employed to narrow down the search for potential valuable combinations.

Dynamic evolution and spatial difference of public health service supply in economically developed provinces of China: typical evidence from Guangdong Province.

OBJECTIVE: The outbreak of the COVID-19 pandemic has drawn attention from all sectors of society to the level of public health services. This study aims to investigate the level of public health service supply in the four major regions of Guangdong Province, providing a basis for optimizing health resource allocation. METHODS: This article uses the entropy method and panel data of 21 prefecture-level cities in Guangdong Province from 2005 to 2021 to construct the evaluation index system of public health service supply and calculate its supply index. On this basis, the standard deviation ellipse method, kernel density estimation, and Markov chain are used to analyze the spatiotemporal evolution trend of the public health service supply level in Guangdong Province. The Dagum Gini coefficient and panel regression model are further used to analyze the relative differences and the key influencing factors of difference formation. Finally, the threshold effect model is used to explore the action mechanism of the key factors. RESULTS: Overall, the level of public health service supply in Guangdong Province is on an upward trend. Among them, polarization and gradient effects are observed in the Pearl River Delta and Eastern Guangdong regions; the balance of public health service supply in Western Guangdong and Northern Mountainous areas has improved. During the observation period, the level of public health services in Guangdong Province shifted towards a higher level with a smaller probability of leapfrogging transition, and regions with a high level of supply demonstrated a positive spillover effect. The overall difference, intra-regional difference and inter-regional difference in the level of public health service supply in Guangdong Province during the observation period showed different evolutionary trends, and spatial differences still exist. These differences are more significantly positively affected by factors such as the level of regional economic development, the degree of fiscal decentralization, and the urbanization rate. Under different economic development threshold values, the degree of fiscal decentralization and urbanization rate both have a double threshold effect on the role of public health service supply level. CONCLUSION: The overall level of public health service supply in Guangdong Province has improved, but spatial differences still exist. Key factors influencing these differences include the level of regional economic development, the degree of fiscal decentralization, and the urbanization rate, all of which exhibit threshold effects. It is suggested that, in view of the actual situation of each region, efforts should be made to build and maintain their own advantages, enhance the spatial linkage of public health service supply, and consider the threshold effects of key factors in order to optimize the allocation of health resources.

Global burden of burns and its association with socio-economic development status, 1990-2019.

BACKGROUND: Burns represent important global health problems. Whereas many studies are limited by the difficulties in estimating the burden of burns and instead focus on the causes of burns, such as fire, heat, and hot substances. Therefore, a complete assessment of the burden of all injuries leading to burns is essential to developing reasonable global intervention strategies. METHODS: Data on three classes of burns, including "< 20 % total burned surface area without lower airway burns" (Moderate injury), "> =20 % total burned surface area or > = 10 % burned surface area if head/neck or hands/wrist involved w/o lower airway burns" (Major injury), "Lower airway burns" (Inhalation injury) were collected from the Global Burden of Disease 2019 database. Age-standardized incidence rates (ASR-I) and Years Lived with Disability (ASR-YLDs) for burns has been standardized by removing the influence of population size and age structure. They were extracted and stratified by cause, year, sex, age, socio-demographic index, country, and territory. RESULTS: In terms of ASR-I and ASR-YLDs, burns showed a significant decrease from 1990 to 2019, especially for moderate and major injury. In 2019, the burden of moderate injury was positively correlated with socio-demographic index while major injury was negatively correlated (P < 0.05). We found no correlation between socio-demographic index and the burden for inhalation injury (P > 0.05). Fire, heat, and hot substances were the most important cause of burns except for inhalation injury. The most common association with inhalation injury was falls, which were also a major cause of moderate and major injury. CONCLUSIONS: The Global Burden of Disease 2019 database data can be used to guide the allocation of resources to reduce ASR-I and ASR-YLDs of different burn classes.

Impact of digital economic development and environmental pollution on residents' health: an empirical analysis based on 279 prefecture-level cities in China.

BACKGROUND: The digital economy based on the internet and IT is developing rapidly in China, which makes a profound impact on urban environmental quality and residents' health activities. Thus, this study introduces environmental pollution as a mediating variable based on Grossman's health production function to explore the impact of digital economic development on the health of the population and its influence path. METHODS: Based on the panel data of 279 prefecture-level cities in China from 2011 to 2017, this paper investigates the acting mechanism of digital economic development on residents' health by employing a combination of mediating effects model and spatial Durbin model. RESULTS: The development of digital economy makes direct improvement on residents' health condition, which is also obtained indirectly by means of environmental pollution mitigation. Besides, from the perspective of spatial spillover effect, the development of digital economy also has a significant promoting effect on the health of adjacent urban residents, and further analysis reveals that the promoting effect in the central and western regions of China is more pronounced than that in the eastern region. CONCLUSIONS: Digital economy can have a direct promoting effect on the health of residents, and environmental pollution has an intermediary effect between digital economy and residents' health; At the same time, there is also a regional heterogeneity among the three relationships. Therefore, this paper believes that the government should continue to formulate and implement scientific digital economy development policies at the macro and micro levels to narrow the regional digital divide, improve environmental quality and enhance the health level of residents.

Potential risk of co-occurrence of microplastics and chlorinated persistent organic pollutants to coastal wetlands: Evidence from a case study.

Microplastic (MP) pollution in coastal wetlands is of a global concern. Little attention has been paid to the co-occurrence and corresponding risk of MPs with pollutants, especially refractory chlorinated persistent organic pollutants (CPOPs). A case study of Zhejiang, China was conducted to investigate the occurrence of MPs and targeted CPOPs in coastal wetlands. MPs were 100% detected, but with the lowest abundance in coastal wetlands (average: 666.1 ± 159.1 items kg-1), as compared to other 6 terrestrial ecosystems (average: 1293.9 ± 163.7 items kg-1) including paddy field, upland, facility vegetable field, forestland, urban soil, and grassland. A total of 35 kinds CPOPs were also detected in all studied coastal wetlands, with their concentration almost under 10 µg kg-1 (90.1%). Both enrichment of MPs and CPOPs was affected by sediment TOC, wetland vegetation and land use simultaneously. Interestingly, the occurrence of MPs was significantly correlated with polychlorinated biphenyls (PCBs) but not organochlorine pesticides (OCPs). Results of co-occurrence pollution assessment of MPs and CPOPs further indicated only Hangzhou Bay showed the ecological risk among all tested wetlands. This would suggest a potential risk of co-occurrence of MPs and modern CPOPs in coastal wetland in economic development area. Possible reason may lie on strong MP vector effect to CPOPs. More attention should thus be paid to other wetlands polluted by MPs and MP-carrying CPOPs in area with relatively great environmental pressure induced by human activity. This study may provide reference for a better understanding with respect to the risk level posed by co-occurrence of MPs and CPOPs to global coastal wetlands.

Curvilinear relationship between burnout and work engagement among staff in community services for the elderly: A correlation study.

Objective: To investigate whether there is a curvilinear relationship between burnout and work engagement among staff in Chinese community services for the elderly. Methods: A stratified whole-group random sampling method was used to survey 244 staff members from eight communities in two cities. Data were collected using the Maslach Burnout Inventory scale (MBI) and the Utrecht Work Engagement Scale- 9 (UWES- 9). The curve estimation method explored the functional model of burnout and work engagement scales. Results: Two hundred forty-four staff members completed the survey. Burnout, depersonalization (DP), and personal accomplishment (PA) were found to be related to work engagement in a cubic function (R2 = 0.166, P < 0.05), (R2 = 0.061, P < 0.05), and (R2 = 0.2230, P < 0.05), respectively. There was no statistically significant relationship between emotional exhaustion (EE) and work engagement (P > 0.05). "Personal Accomplishment" is related to work engagement in a U-shaped curve. Conclusions: There was a cubic function relationship between burnout and work engagement, where "personal accomplishment" was related to work engagement in a U-shaped curve. Therefore, the government and related service organizations should understand the impact of different levels of burnout on work engagement and take targeted measures to alleviate burnout and improve work engagement by targeting emotions and stroke.

A Heterogeneity Study of Carbon Emissions Driving Factors in Beijing-Tianjin-Hebei Region, China, Based on PGTWR Model.

The Beijing-Tianjin-Hebei region is an important economic growth pole in China and achieving carbon emission reduction in the region is of great practical significance. Studying the heterogeneity of the influencing factors of carbon emission in this region contributes to formulating targeted regional carbon emission reduction policies. Therefore, this paper adopted thirteen cities as individuals of cross-section and conducted spatial and temporal heterogeneity analysis of the influencing factors of converted carbon emissions in the region with panel data from 2013 to 2018 based on the PGTWR model. From a space-time perspective, the regression coefficient of each influencing factor in this region has obvious heterogeneity, which is mainly reflected in the time dimension. In the study period, the impact of industrial structure, the level of urbanization, energy intensity, and the level of economic growth on carbon emission showed a decline curve, while the impact of the level of opening up and the size of population was on the rise, indicating that more attention should be paid to the latter two factors for the time to come. In terms of space, the differences in the influence of industrial structure and energy intensity on carbon emission vary significantly.

A comprehensive assessment of upgrading technologies of wastewater treatment plants in Taihu Lake Basin.

To meet the increasingly stringent discharge standards of wastewater treatment plants (WWTPs) in the Taihu Lake Basin, the Chinese government successively established the National Special Water Project Program to develop new technologies to retrofit and upgrade existing wastewater treatment processes during the 11th, 12th, and 13th Five-Year Plans. However, there is a lack of systematic sorting of the existing research outcomes, and thus hinders the application and promotion of the upgrade technologies. Based on the outcomes of the National Special Water Project and a field survey, this research analyzed the current status of wastewater treatment in the Taihu Lake Basin and systematically integrated the retrofitting measures of WWTPs in terms of achieving the Grade IA of the national standard and local stricter discharge standards (DB 32/1072-2018 and DB 33/2169-2018). In particular, the boundary conditions, design parameters, specific recommendations of the technologies, and some typical engineering cases were provided accordingly. Finally, this study discussed the future development directions of WWTPs during the upgrade process from the perspective of carbon neutrality and digitalization. The present work will hopefully assist in retrofitting and constructing WWTPs to achieve the stricter effluent discharge criteria and help optimize the design and construction of WWTPs in the best way.

Integration of life cycle assessment and life cycle costing for the eco-design of rubber products.

Rubber hoses are a category of rubber products that are widely and intensively employed in construction sites for concrete conveying. There has been lack of study to investigate the life cycle environmental and economic impacts of the rubber hoses as an industrial product. In this study, we analyze four types of rubber hoses with the inner layer made of different rubber composites to resist abrasion, i.e., Baseline, S-I, S-II and S-III. Tests of the wear resistance are carried out in the laboratory and S-III shows high abrasion resisting performance with the concrete conveying volume up to 20,000 m3 during the service life. Life cycle assessment (LCA) and life cycle costing (LCC) models are established for evaluating the four types of rubber hoses. A target function is developed to integrate LCA and LCC by converting the LCA results to the environmental costs. It is found that S-III can save 13% total cost comparing to Baseline. The production stage is the largest contributor to the environmental single score, while the use stage is the largest contributor to the life cycle cost. Sensitivity analyses are conducted and the results of this study are validated with the previous studies. The integrated method of LCA and LCC developed in this study paves a way for the eco-design of industrial rubber hoses and is potentially applicable to other rubber products.

Perceived participation and autonomy structural relationships among related factors in patients with stroke and hypertension in China: A ISM model approach.

Aims: To explore the structural relationship between perceived participation and autonomy among older adults with stroke and hypertension in home and community-based services (HCBSs) in the eastern coastal region of China. Design: An explorative cross-sectional study. Methods: From July to September 2021, a total of 714 respondents were reported to have stroke and hypertension, and their information was used in the analysis of this study. A multiple linear regression analysis was used to explore the factors influencing factors older adults' perceived participation and autonomy. Using the ISM model, we analyzed the factors affecting social participation in patients with stroke and hypertension and explained the logical relationships and hierarchy among the factors. Results: The mean score of perceived participation was 58.34 ± 27.57. Age, marital status, health insurance, living status, number of children, chronic diseases, sleep time, frequency of outings, and health utility value were significant factors affecting perceived participation and autonomy with stroke and hypertension patients. Among them, health insurance is the direct factor on the surface, age, number of children, chronic diseases, sleep time, frequency of outings, and health utility value are the intermediate indirect factors, and marital status and living status are the deep-rooted factors. Conclusion: By the study that the hierarchical structure provides a visualization of interrelationships and interdependences among the influencing factors of perceived participation and autonomy. It also may be a significant complement to traditional variable-entered approaches and construct an optimized multidimensional perspective of participation and autonomy. Future research should focus on optimizing the living environment of older adults with stroke and hypertension to explore the model of rehabilitative intervention and help patients successfully reintegrate into their families/societies.

Assessment of Corrosion Protection Performance of FeOOH/Fe3O4/C Composite Coatings Formed In Situ on the Surface of Fe Metal in Air-Saturated 3.5 wt.% NaCl Solution.

The purpose of this work is to evaluate the corrosion-inhibition behavior of deposited carbon and some iron-oxide hybrid coatings which derived from the in situ deposition method on the surface of Fe foil. Various contents of precursor methane gas were deposited over a mild iron foil substrate and formed different composites. It was found that the incorporation of C into the Fe matrix led to a thin film on the surface of the matrix and produced an anti-corrosion effect. Electrochemical impedance spectroscopy (EIS), potentiodynamic polarization and potentiometric tests were used to compare the corrosion behaviors of the films in air-saturated 3.5 wt.% NaCl solution. According to the results, Fe-oxide- and C-composite-coated iron foil has a much higher corrosion resistance than the raw blank sample without the addition of C. Generally, the corrosion charge transfer resistance of one kind of iron oxide coated with carbon layers of several nanometers was enhanced up to 28,379 times (Rct changes from 1487 Ω cm2 to 4.22 × 107 Ω cm2), which is the biggest improvement so far. The maximum protection efficiency was obtained for the in situ grown coating prepared by 10 and 15 sccm CH4 precursor gas (eta = 100%). In conclusion, an iron oxide and carbon composite was found to be a great candidate for applications in the corrosion-resistance area.

A low-cost photo-evaporation inorganic membrane preparation and treatment of the simulated high salinity radioactive waste water.

Solar-driven desalination is an energy-saving and environmentally benign wastewater treatment technology. A method of in situ self-reduction of graphene oxide (rGO) by cheap geopolymer was introduced, and a photo evaporation membrane device (rGOPGC) for treatment of the simulated high salt liquid radioactive waste (HSLRW) was prepared in the present study. Compared with other rGO based photo evaporation membrane materials, geopolymer matrix has the advantages of low cost, reductant free, simple preparation process and mild conditions. After desalination of simulated seawater, the concentrations of Na+, K+, Ca2+ and Mg2+ ions reached the WHO standard, and the removal rates of radioactive I-, Cs+ and Sr2+ in the simulated high salinity wastewater reached 99.62%, 99.71% and 99.99% respectively; The evaporation rate of rGOPGC remained stable at 1.5 kg/m2/h after 16 cycles in high salinity environment. There was no obvious salt accumulation on the upper surface of the device, indicating its high stability. Furthermore, the evaporation performance at high temperature near the nuclear power plant (NPP) waste water was simulated and tested. Under one solar intensity and 35 °C ambient temperature, the evaporation rate of 1.75 kg/m2/h and the evaporation efficiency of 98.51% were achieved. The results indicated that the rGOPGC device is potential in the concentration evaluation of HSLRW.

Global, regional, and national prevalence, disability adjusted life years, and time trends for refraction disorders, 1990-2019: findings from the global burden of disease study 2019.

BACKGROUND: To evaluate global burden of refraction disorders by year, age, region, gender, socioeconomic status and other national characteristics in terms of disability adjusted life years (DALYs) and prevalence from Global Burden of Disease (GBD) study 2019 and World Bank Open Data 2019. METHODS: Global, regional, and national DALY numbers, crude DALY rates, age-standardized DALY and prevalence rates of refraction disorders were acquired from the GBD study 2019. Mobile cellular subscriptions, urban population, GDP per capita, access to electricity and total fertility rate were obtained from the World Bank to explore the factors that influenced the health burden of refraction disorders. Kruskal-Wallis test, linear regression and multiple linear regression were performed to evaluate the associations between the health burden with socioeconomic levels and other national characteristics. Wilcoxon Signed-Rank Test was used to investigate the gender disparity. RESULTS: Globally, age-standardized DALY rates of refraction disorders decreased from 88.9 (95% UI: 60.5-120.3) in 1990 to 81.5 (95% UI: 55.0-114.8) in 2019, and might fall to 73.16 (95% UI: 67.81-78.51) by 2050. Age-standardized prevalence rates would also reduce to 1830 (95% UI: 1700-1960) by 2050, from 2080 (95% UI: 1870-2310) in 1990 to 1960 (95% UI: 1750-2180) in 2019. In low SDI region, age-standardized DALY rates (equation: Y = 114.05*X + 27.88) and prevalence rates (equation: Y = 3171.1*X + 403.2) were positively correlated with SDI in linear regression respectively. East Asia had the highest blindness rate caused by refraction disorders in terms of age-standardized DALY rates (11.20, 95% UI: 7.38-16.36). Gender inequality was found among different age groups and SDI regions. CONCLUSION: Health burden of refraction disorders decreased in recent years, and may continue to alleviate in the next three decades. Older ages, females and lower socioeconomic status were associated with higher refraction disorders health burden.

Efficiency and comprehensive risk assessment of soil Pb and Cd by washing technique with three biodegradable eluents.

Soil washing with environmentally friendly eluents is a rapid remediation technique for farmland polluted by heavy metals. In this study, polyepoxysuccinic acid (PESA), ethylenediamine tetra (methylene phosphonic acid) sodium (EDTMPS), and phosphonyl carboxylic acid copolymer (POCA) were applied to remedy paddy and arid soils polluted by Pb and Cd. At the same time, ethylenediaminetetraacetic acid (EDTA) was used as a control eluent. PESA showed comparable removal of soil Pb and Cd (over 80.0%) with EDTA, and EDTMPS and POCA removed two heavy metals by 35.2-50.3%. For labile fractions, PESA significantly removed Pb by 93.5-96.7% and Cd by 84.9-90.3% in two soils. EDTMPS and POCA removed Pb by 75.5-85.8% in two soils, while they only removed Cd by 11.7-42.2% in paddy soil, and 76.3-81.7% in arid soil. The risks of total heavy metal concentrations were reduced from the high risk to low risk in paddy soil, and to considerable risk in arid soil, while only dropped to considerable or even had no change by EDTMPS and POCA leaching. The risks of the two soils reduced from high to low or considerable level after PESA washing based on labile fraction change, and to considerable or high level after EDTMPS and POCA leaching, respectively. Therefore, PESA is an ecological benefit eluent for remediating the farmland polluted by heavy metals, and the risk assessment based on labile fraction more easily identifies the dynamic change of heavy metal during the washing process.

Assessment of different induction chemotherapy regimens in locally advanced nasopharyngeal carcinoma: Meta-analysis.

BACKGROUND: A Bayesian network meta-analysis was performed to compare the efficacy and toxicities among different induction chemotherapy regimens in locally advanced nasopharyngeal carcinoma (LA-NPC). METHODS: Electronic databases were searched for literature up to September 16, 2019. Two researchers independently selected the articles, evaluated the quality of the literature, and extracted and analyzed the data. RESULTS: There were no significant differences in survival outcomes, mucositis, or gastrointestinal adverse events among the four regimens. The probability of GP being the best induction scheme to improve OS was 43.7%. The completion rate of concurrent chemotherapy with the GP regimen was significantly reduced than the other three regimens. CONCLUSIONS: The survival outcomes of the four regimens in LA-NPC were comparable. Considering only OS, GP showed the highest probability of improving the survival of LA-NPC, while it also affected the completion of concurrent chemotherapy.

Diagnostic efficacy of PET-CT, CT, and MRI in preoperative assessment of mandibular invasion caused by head and neck cancer: A systematic review and meta-analysis.

OBJECTIVE: This study aims to conduct a systematic review and meta-analysis of the performance of PET-CT, CT, and MRI in diagnosing mandible invasion induced by head and neck cancer (HNC). MATERIALS AND METHODS: The MEDLINE, Embase, Science Direct, CNKI and CQVIP databases were searched from inception until August 1, 2020. Then, a meta-analysis was conducted to calculate the combined diagnostic values with the corresponding 95% CIs. Two independent researchers completed the full text screening, data abstraction, and risk assessment. RESULTS: This meta-analysis included 53 studies (N = 2 946 participants). For the pooled sensitivity (SEN), MRI (SEN: 0.88, 95% CI: 0.81-0.93) was found to have a significantly higher SEN (P = 0.0045), when compared to CT (SEN: 0.77, 95% CI: 0.71-0.82), while compared with PET-CT (SEN: 0.88, 95% CI: 0.64-0.97), the SEN was approximately equal (P > 0.05). The analysis revealed that the combined specificity (SPE) of MRI (SPE: 0.83, 95% CI: 0.74-0.89) and PET-CT (SPE: 0.81, 95% CI: 0.57-0.93) was lower than that of CT (SPE: 0.87, 95% CI: 0.83-0.90), but there was no statistical significance among these (P > 0.05). The comparison of the area under curve (AUC) reflected that PET-CT, CT and MRI have approximately equal summary diagnostic power in detecting mandibular invasion (P > 0.05). CONCLUSION: The findings suggest that compared with CT, MRI is significantly superior for higher SEN in diagnosing mandibular invasion. The SEN of MRI and PET-CT were approximately equal. For the summary of diagnostic power, more prospective clinical trials that directly compare these three methods are needed in the future.

Health literacy of college freshmen in jiangsu, China: A 3-year longitudinal survey.

ABSTRACT: Health literacy (HL) has become an important public health issue and received growing attention in recent years. However, knowledge about the HL of adolescents and young adults is limited.[1] This study aimed to investigate the awareness rate of HL and its related factors among college freshmen in Jiangsu, China. And the results were used to support the promotion intervention to improve the HL of at-risk groups among this population.A total of 25,272 freshmen were surveyed through multi-stage stratified random sampling from 20 colleges and universities in Jiangsu province between 2016 to 2018. Data were obtained using the "Chinese Citizen Health Literacy Questionnaire" (2013 edition). Multiple logistic regression analysis was conducted to determine the factors influencing HL levels.The awareness rate of HL of college freshmen in Jiangsu province was 26.6% among the 25,272 subjects. The awareness rate of HL tended to increase from 2016 to 2018, which was 17.9%, 21.5%, and 39.6%, respectively (P < 0.001). Specifically, except for chronic diseases, knowledge and attitudes, knowledge and attitudes toward health-related behavior and lifestyle, health-related skill and scientific views of health, infection diseases, safety and first aid, medical care, health information awareness rate all have improved to a certain degree (P < .001). The independent factors associated with HL awareness rate were sex (odds ratio [OR] = 1.099, (1.039 -1.164)), residence (urban: OR = 1.141, (1.056∼1.234)), educational system (OR = 2.133, (1.975-2.305)), only child or not (OR = 1.087, (1.018-1.161)), family structure (OR = 1.192, (1.078-1.319)) and maternal education level (high school: OR = 1.183 (1.067-1.313); university and more: OR = 1.481 (1.324-1.658)).Awareness rate of HL of college freshmen is associated with multi-complex factors, further works are recommended to improve the HL levels of college freshmen, especially for the aspect of chronic diseases.